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Schatzki Ring — RACP Adult Medicine MCQ

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EasyGastroenterology & HepatologySchatzki RingRACP Adult Medicine

A 50-year-old man presents with progressive dysphagia for solids. He has a history of long-standing GORD and is on high-dose PPI therapy. Upper endoscopy reveals a Schatzki ring at the gastro-oesophageal junction with a ring diameter of 11 mm. What is the most appropriate treatment?

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Correct answer: A — Increase PPI dose

A Schatzki ring is a mucosal ring at the squamocolumnar junction (Z-line) that causes intermittent dysphagia for solids (classically the 'steakhouse syndrome'). Rings <13 mm diameter are almost always symptomatic. Treatment is endoscopic dilation (bougie or through-the-scope balloon) which provides immediate symptom relief. PPI therapy post-dilation reduces ring recurrence. Repeat dilation may be needed. The association with GORD and hiatal hernia is well-established.

Reference: eTG – 2025 – Gastrointestinal; ACG – 2020 – Dysphagia Guidelines